In the Pink: Digital breast tomosynthesis is the ‘Cadillac’ of breast cancer screening

Digital breast tomosynthesis is yet another advance toward helping doctors catch cancers when they are in their earliest stages and can be treated most effectively, said Yavapai Regional Medical Center BreastCare Center Director Nancy Ledoyen.

This “Cadillac” brand of technology still requires breast compressions, but the discomfort is short lived and the results can be life-saving, affirmed Ledoyen, a licensed oncology nurse.

To explain how this technology works, Ledoyen said it is like someone holding up a two-dimensional book. You can see the covers clearly, and maybe some chapter heads, but not the words on the page.

“This allows us to leaf through the pages,” Ledoyen said.

The technology is known to find 41 percent more aggressive cancers, and can reduce by about 40 percent the need for patients to have repeat mammograms because of false, positive results, according to Ledoyen and other Yavapai Regional Medical Center officials.

“In Yavapai County, we have one of the highest later-stage cancer detection rates in Arizona,” said Mary Sterling, the hospital’s director of imaging services. Bringing this advanced technology to western Yavapai County has added to the tools we have available to diagnose and treat breast cancer. Allowing our patients to receive the best care possible, close to home, is very important to us.”

When digital breast tomosynthesis first became available in 2012/2013, Ledoyen said it was most commonly believed to be the preferred screening method for women with dense breasts. But time has revealed that this advanced tool is also good for post-menopausal women where glands have been replaced with fat tissue, Ledoyen said.

Breast cancers do not tend to just appear, but rather develop over a period of one to five years, with mammograms important as they detect the subtle changes that can occur in breast tissue that might signal the need for more in depth study, Ledoyen said.

Mammograms are the first screening step that may then require follow up with ultrasound, and in some cases a breast MRI (Magnetic Resonance Imaging) for a definitive diagnosis, she said.

For women of average risk, the American College of Radiology recommends a baseline mammogram for every woman by age 40 and then annually thereafter. Those with genetic predisposition to breast cancer, or who may have other factors that heighten their risk, may be referred for one at earlier ages, Ledoyen said.

The ultimate hope is that this type of mammogram becomes the gold standard for all patient screenings, but as with any new technology doctors want to be certain it “lives up to the hype” and is worth the extra time and study required to interpret results, Ledoyen said.

On a weekly basis, Ledoyen said she sees the advantage because radiologists report finding possible cancers that they would have gone undetected on a 2-D scan, she said.

“Catching breast cancer at an early stage, before it has spread, has been proven to save lives,” radiologist Dr. Brian Kimball said in a hospital article about the new technology.

The drawback to this technology, as with any new medical advancement, is the expense.

Medicare and Medicaid will cover the screenings for its eligible patients, but private insurance often requires patients to cover the difference between the two screenings, which is about $150. Ledoyen, Kimball and other hospital officials have high hopes this will soon change.

“I don’t want to play God, saying who gets it and who doesn’t,” Ledoyen said.